A couple of years ago, I wrote a piece on a comparative analysis of 3 rural health literacy programs. Today, we revisit the topic. The rolling plains of rural America have long been romanticized as the heartland, a place where small towns thrive on community ties and quiet perseverance. Yet for millions living in these vast stretches, understanding and navigating the healthcare system remains an enduring struggle. It is a silent crisis, one where a lack of health literacy can mean the difference between managing a chronic condition and letting it spiral, between accessing life-saving care and falling through the cracks.
This challenge is not new, but the solutions are evolving. Over the past two years, a wave of innovative programs has emerged, reshaping how health information reaches rural communities. From Texas to North Carolina, these initiatives are tackling the digital divide, bolstering maternal care, and even leveraging tiny neighborhood book exchanges to deliver vital health knowledge. And at the heart of many of these efforts stands an agency few people know about: the Health Resources and Services Administration (HRSA).
HRSA: The Silent Guardian of Rural Healthcare
Operating under the U.S. Department of Health and Human Services (HHS), HRSA plays a crucial but often overlooked role in ensuring healthcare reaches America’s most underserved communities. It funds rural hospitals, maternal health programs, telehealth initiatives, and workforce development, acting as a safety net for millions of Americans who might otherwise struggle to access medical care.
“Health literacy isn’t just about being able to read a prescription label,” says Dr. Maria Thompson, a public health specialist focusing on rural healthcare disparities. “It’s about understanding how to prevent illness, when to seek care, and where to find reliable medical information. And in rural America, all of those steps come with barriers.”
Texas A&M’s Bold Bet on Rural Healthcare
In January 2024, Texas A&M University launched its Rural Engagement Program, an ambitious effort to strengthen healthcare in the state’s underserved regions. The initiative brings together medical and nursing schools, rural hospitals, and local providers with a singular goal: to improve healthcare access and literacy through education, financial support, and technology.
A core component of the program focuses on workforce expansion—providing scholarships to rural nurses, offering hands-on training to medical students, and exposing K-12 students to careers in healthcare. But perhaps most critical is its investment in telehealth and digital literacy.
“If a patient doesn’t understand how to use a telehealth platform, it’s as if the service doesn’t exist for them,” says Dr. Thompson. “We need to make digital tools as intuitive and accessible as possible.”
The Fight for Maternal Health in the Heartland
Nowhere is the gap in health literacy more dangerous than in maternal care. Rural hospitals have been shuttering obstetric units at an alarming rate, leaving expectant mothers to travel hours for prenatal appointments—if they get them at all. The consequences can be devastating, contributing to higher maternal and infant mortality rates in these communities.
Enter HRSA’s Rural Maternity and Obstetrics Management Strategies (RMOMS) program. Launched in 2019 and expanded in 2023, RMOMS builds networks among hospitals, clinics, and telehealth providers to ensure continuous care throughout pregnancy and beyond.
One of its greatest successes has been in leveraging technology. “Telemedicine isn’t just about doctor visits,” explains Dr. Lisa Reynolds, an obstetrician involved with the initiative. “It’s about education—helping mothers understand nutritional needs, warning signs of complications, and the importance of postpartum care.”
Little Free Libraries: A Grassroots Approach to Health Literacy
While high-tech solutions are making waves, one of the most innovative health literacy programs takes a decidedly low-tech approach. The National Network of Libraries of Medicine (NNLM) has partnered with rural communities to stock Little Free Libraries—not just with novels and children’s books, but with health resources.
These unassuming wooden boxes, often perched in front yards or near community centers, have become vital conduits for information on everything from managing diabetes to understanding mental health. In North Carolina, one project distributed evidence-based health pamphlets across a network of 500 libraries, reaching residents who might never walk into a clinic.
“It’s about trust,” says Rebecca Simmons, a librarian leading the effort. “People may not go looking for health information, but if it’s in their neighborhood, if it’s part of their daily life, they’re more likely to engage with it.”
HRSA: The Engine Behind Many Rural Health Initiatives
What many people don’t realize is that HRSA is the driving force behind countless rural health programs. Beyond maternal health and rural hospitals, its initiatives span multiple areas:
- The Rural Health Care Program – Supports telecommunications and broadband access for rural healthcare providers.
- The National Health Service Corps (NHSC) – Offers scholarships and loan repayment for healthcare providers working in high-need areas.
- The Nurse Corps Program – Provides financial incentives for nurses in underserved regions.
- The Telehealth Network Grant Program – Expands telehealth systems for remote communities.
- The Healthy Start Program – Reduces infant mortality through expanded prenatal care.
- Community Health Workers (CHWs) Training Programs – Trains local healthcare educators to improve patient outreach.
HRSA acts as the safety net for millions who lack easy access to healthcare. By focusing on workforce shortages, rural infrastructure, maternal health, and health literacy, it ensures that the most vulnerable populations, rural communities, low-income families, and medically underserved individuals, receive the care they need.
The Road Ahead
Health literacy in rural America remains a complex and evolving challenge. Solutions must be multifaceted—embracing digital innovation while also recognizing the power of community-driven, human-centered approaches.
The Texas A&M program, RMOMS, and the Little Free Libraries initiative highlight a fundamental truth: improving health outcomes isn’t just about delivering care. It’s about ensuring that people understand, trust, and can act on the information they receive.
For those working to bridge the gap, the mission is clear. “Health literacy is empowerment,” says Dr. Thompson. “And in rural America, empowerment can save lives.”
Wonderful ♥️